日托中心儿童鼻腔耐甲氧西林金黄色葡萄球菌携带情况及其抗生素敏感性模式

Nasal carriage of methicillin resistant Staphylococcus aureus and their antibiotic susceptibility patterns in children attending day-care centers.

作者信息

Sedighi Iraj, Moez Hoda Jaefari, Alikhani Mohammad Yousef

机构信息

Hamadan University of Medical Sciences, Department of Pediatrics, Faculty of Medicine, Hamadan, Iran.

出版信息

Acta Microbiol Immunol Hung. 2011 Sep;58(3):227-34. doi: 10.1556/AMicr.58.2011.3.6.

Abstract

Nasal colonization with community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is being increasingly reported, especially in places where people are in close contact and in reduced hygiene, such as day-care centers. In this study we investigated the frequency of MRSA colonization and their antibiotic susceptibility patterns in 1-6 years old children of day-care centers in Hamadan, West of Iran.Five hundred nasal swabs were collected from children of 27 day-care centers that had no risk factors for colonization by S. aureus. The specimens were cultured for isolation of S. aureus by standard methods. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. For evaluation of the frequency of erythromycin induced clindamycin resistance, disk approximation test (D-test) was applied.Totally, 148 (29.6%) children were colonized by S. aureus. Out of 260 male, 94 (36.2%) and of 240 female, 54 (22.5%) cases were nasal carriers of S. aureus (P value = 0.001). Six (4.1%) of the 148 S. aureus isolated from children were MRSA strains. None of MRSA and methicillin susceptible S. aureus (MSSA) was resistant to vancomycin and clindamycin. Three of the 6 strains of MRSA and 7 (4.9%) of the 142 MSSA strains were resistant to erythromycin, and D-test was positive in all of them.We conclude that the rate of colonization by S. aureus is high in children attending day-care centers but colonization with MRSA is not common in our areas. Clindamycin or trimethoprim-sulfamethoxazol could be used in mild to moderataly severe diseases caused by CA-MRSA. However, if the CA-MRSA isolates are erythromycin resistant, D-test should be carried out for detection of inducible clindamycin resistance.

摘要

社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)的鼻腔定植报告日益增多,尤其是在人员密切接触且卫生条件较差的场所,如日托中心。在本研究中,我们调查了伊朗西部哈马丹日托中心1至6岁儿童中MRSA定植的频率及其抗生素敏感性模式。

从27个无金黄色葡萄球菌定植危险因素的日托中心的儿童中采集了500份鼻拭子。采用标准方法培养标本以分离金黄色葡萄球菌。根据临床和实验室标准协会(CLSI)指南进行抗菌药物敏感性试验。为评估红霉素诱导的克林霉素耐药频率,应用纸片扩散法(D试验)。

共有148名(29.6%)儿童被金黄色葡萄球菌定植。在260名男性中,94名(36.2%),在240名女性中,54名(22.5%)为金黄色葡萄球菌鼻携带者(P值 = 0.001)。从儿童中分离出的148株金黄色葡萄球菌中有6株(4.1%)为MRSA菌株。MRSA和甲氧西林敏感金黄色葡萄球菌(MSSA)均对万古霉素和克林霉素敏感。6株MRSA菌株中有3株以及142株MSSA菌株中有7株(4.9%)对红霉素耐药,且所有这些菌株的D试验均为阳性。

我们得出结论,日托中心儿童的金黄色葡萄球菌定植率较高,但我们地区MRSA定植并不常见。克林霉素或甲氧苄啶 - 磺胺甲恶唑可用于治疗由CA-MRSA引起的轻至中度严重疾病。然而,如果CA-MRSA分离株对红霉素耐药,则应进行D试验以检测诱导性克林霉素耐药。

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